1. Calhoun County Infant Safe Sleep Coalition
Thank you for the opportunity to talk about our community’s most vulnerable citizens---our babies.
Introduce yourself---if appropriate, add a comment about why you chose to join the Coalition.
Presented by:
Calhoun County Infant Safe Sleep Coalition

2. By the end of the presentation you will:
Have an awareness of the issue
Know prevention strategies
See the value in informing others
Know the importance of becoming an Infant Safe Sleep Advocate

3. The Problem These are preventable deaths!
Too many infants around the state and
in Calhoun County are dying in unsafe sleep environments.
These are preventable deaths!

4. Infant Deaths: Michigan
Live Births
Deaths Before Age 1
Rate per 1,000 births
2010
114,717
817
7.1
2011
114,159
749
6.6
2012
112,708
783
6.9
2013
113,732
799
7.0
2014
114,460
773
6.8
Source: Michigan Department of Health & Human Services

5. Infant Deaths: Calhoun County
Live Births
Deaths Before Age 1
Rate per 1,000 births
2010
1,646 18
10.9
2011
1,616 15
9.3
2012
1,681 10
5.9
2013
1,697 11
6.5
2014
1,659 9
5.4
Source: Michigan Department of Health & Human Services

6. Infant Mortality Rate: County to State to National Comparison
Source: Michigan Department of Health & Human Services

7. Sudden Unexpected Infant Deaths due to Accidental Suffocation and SIDS:
Calhoun County
Sudden Infant Death Syndrome (SIDS) is defined as the sudden death of an infant less than 1 year of age that cannot be explained after a thorough investigation is conducted, including a complete autopsy, examination of the death scene, and review of the clinical history. For a medical examiner or coroner to determine the cause of the death, a thorough case investigation including examination of the death scene and a review of the infant’s clinical history must be conducted. A complete autopsy needs to be performed, ideally using information gathered from the scene investigation. Even when a thorough investigation is conducted, it may be difficult to separate SIDS from other types of sudden unexpected infant deaths, especially accidental suffocation in bed.

8. Infant Death Rate due to Accidental Suffocation in Bed

9. Infant Death Rate due to SIDS

10. Safe Sleep Recommendations
Place baby on back for every sleep time.
Use a firm mattress with tightly fitted sheet – no loose bedding.
Baby should sleep in the same room as the parents, but not in the same
bed (room-sharing without bed-sharing).
Baby should sleep alone in a crib, portable crib, or bassinet.
Nothing in sleep area: no pillows, blankets, comforters, stuffed
animals, bumper pads, or other soft items.
Do not smoke during pregnancy and avoid an infant’s
exposure to second-hand smoke.
Avoid alcohol and illicit drug use during pregnancy and after birth.
It’s gratifying to know that we in Michigan are not facing this issue alone. The American Academy of Pediatrics published original recommendations in 2000 and revised them in 2005, made new additions in 2011, and again in strengthening their position on the importance of a safe sleep environment for babies. Review the slide.
These are recommendations for infants up to 12 months of age.
Additional points to make:
After feeding baby, put baby back in his/her own crib to sleep.
Bedsharing is a leading factor in infants deaths in Calhoun County.
*Recommendations from American Academy of Pediatrics: Task Force on SIDS (2016)

11. Safe Sleep Recommendations
Offer a pacifier at nap time and bed time. (For breastfed infants, delay
pacifier introduction until breastfeeding has been firmly established, usually
3-4 weeks of age.)
Breastfeeding is recommended.
Infants should be immunized. Evidence suggests
that immunization reduces the risk of SIDS by 50%.
Do not use home apnea monitors or commercial devices marketed to
reduce the risk of SIDS.
Avoid covering baby’s head or dressing the baby too warmly. Dress the baby in as much or as little clothing as you are wearing.
Encourage tummy time when infant is awake and observed.
Review the slide.
On pacifier use: Published case-control studies demonstrate a significant reduced risk of SIDS with pacifier use, particularly when placed for sleep.
*Recommendations from American Academy of Pediatrics: Task Force on SIDS (2016)

12. Important New Evidence for the 2016 AAP Recommendations
Room share with infants, but not sharing the same sleep surface, for a least the first 6 months – preferably the until the baby is 1 year. Room sharing decreases the risk of SIDS by as much as 50%.
Infants are at a heightened risk for SIDS between 1 and 4 months, new evidence shows that soft bedding continues to pose hazards to babies who are 4 months and older.
There is no evidence to recommend swaddling as a strategy to reduce the risk of SIDS.
Important new evidence were included in the 2016 recommendations.
Review the slide.
*Recommendations from American Academy of Pediatrics: Task Force on SIDS (2016)

13. Lessons from death scenes
Prone position, soft bedding
The strongest reasons for addressing the infant sleep environment come from the death scenes themselves. The following series of pictures reflect actual infant deaths. These pictures use a doll to re-enact the scene. Identify the unsafe environmental factors. Would these babies be alive today if they had been placed to sleep in a safe environment?

14. Lessons from death scenes
Soft bedding / prone position / head covered
The strongest reasons for addressing the infant sleep environment come from the death scenes themselves. The following series of pictures reflect actual infant deaths. These pictures use a doll to re-enact the scene. Identify the unsafe environmental factors. Would these babies be alive today if they had been placed to sleep in a safe environment?

15. Lessons from death scenes
Wedging
The strongest reasons for addressing the infant sleep environment come from the death scenes themselves. The following series of pictures reflect actual infant deaths. These pictures use a doll to re-enact the scene. Identify the unsafe environmental factors. Would these babies be alive today if they had been placed to sleep in a safe environment?

16. Hazardous Sleep Environments for Infants
Sleeping with or on others; including mothers falling asleep while breastfeeding
Unsafe infant bedding, such as, loose bedding, pillows, heavy quilts, blankets, toys, bumper pads
Unsafe infant sleeping locations, such as, adult beds, waterbeds, couches, chairs, swings, car seats X X
So, are babies dying in unsafe sleep environments in Calhoun County? I want to share some true stories of how babies have died in our area.
* A 3 month old is found sleeping prone (on stomach) on a futon mattress. A 21 year old relative is sleeping on the same mattress. The adult relative’s leg is over the baby, compressing the rib cage.
* A 28 day old baby is found in an adult bed with the mother and two siblings. There are two cribs in the house.
* A teen mother falls asleep on the couch while breastfeeding her baby. Grandmother checks the baby 15 minutes before baby is found deceased in mother’s arms.
* A 2 month old baby is found face down on a pillow with a comforter covering the body.
This slide lists hazardous sleep environments that are common features at the scenes of infant deaths.
Explain why car seats and swings can be hazardous, i.e. head drop too low and cuts off air.

17. Beyond Back to Sleep…….
The back sleep position, by itself, is not protective when the infant’s sleep environment is unsafe.
We need to move beyond “Back to Sleep” to teaching infant safe sleep environment.
Many of the babies that die in Michigan are, in fact, on their backs. But, the back sleep position could not protect them from other sleep environment hazards. Our message to those who care for babies must include information about the entire sleep environment.

18. Our Community Response
The Calhoun County Infant Safe Sleep Coalition was formed in 2006 to address the increasing incidence of preventable infant deaths.

19. Calhoun County Infant Safe Sleep Coalition Partners & Advocates
Medical Examiner
Michigan Department of Health and Human Services
Oaklawn Hospital
Physicians
Regional Health Alliance
Summit Pointe
Bronson Battle Creek
Calhoun County Public Health Department
Nurse-Family Partnership
WIC
Early Childhood Connections
Educators
Grace Health
Many of these partners have also contributed to the PNP fund that is housed at the Battle Creek Community Foundation.
We have also received donations from community groups such as the Junior League of Battle Creek and the Kiwanis Club.

20. Every baby is placed in a safe sleep environment.
Our Goal
Every baby is placed in a safe sleep environment.

21. What can you do? Assess your policies and practices
Revise if necessary to reflect infant safe sleep recommendations
Share information with parents and other caretakers
Advocate for infant safe sleep
Provide resources to those caring for babies

22. Resources Available To You
Safe Sleep Tip Cards
*Available in English, Spanish, and Burmese
Safe Sleep Brochure
*Available in English and Spanish
Safe Sleep Videos
Safe Sleep Posters
Pack-N-Play Program
Refer to 211
Presentations / Training
** borntobehealthy.org

23. Questions or Comments?

24. For more information contact: Infant Safe Sleep Coalition
Thank You!
For more information contact:
Infant Safe Sleep Coalition
Audra Brummel
Michigan Department of
Health and Human Services (800)